What happens at a forensic medical examination following a rape or sexual assault

Nobody wants to have a rape exam. No one. That is a realistic place to start. This is not going to be great - but it does not have to make your trauma worse.

I am a senior nurse who works in the service that provides forensic medical examination following a sexual assault or rape. I feel very privileged to be asked to write a blog for Edinburgh Rape Crisis Centre (ERCC) about what happens in these examinations, what we are trying to achieve, and what you can expect.

Intimate examinations take place when a person makes a complaint to the police of rape or sexual assault. After you have been interviewed by a specially trained officer called a ‘SOLO’ (sexual offences liaison officer), you will have the opportunity to have a medical examination.

Consent is the key word here. If you prefer, you can ask for a female examiner – and we will do our best to provide one. If this is not possible - you can ask for a female nurse chaperone. This is what I would advise. You can also bring someone you trust in with you - your mum, your friend, your support worker. That is ok too. The order of the day is to get this examination done as efficiently and quickly as possible.

The doctor, who is called a forensic physician (FP), will already have been briefed by the SOLO. This means that you do not have to repeat your story. The FP will go through what consent actually means in this type of examination - this is to prepare you for the legal process. You can withdraw your consent at any time during this process - you will not offend anyone. We will all be in complete support of you from start to finish.

Getting the forensic samples is important for many reasons. The principle of forensic examination, which is true in all crimes, is that ‘every contact leaves a trace’. Your story and experience is real. However, the Court needs this to be corroborated (that it is backed up by another source of information) and forensic samples are a HUGE part of that.

By taking swabs and samples from your body, the labs can identify who the DNA on or your body belongs to. They can establish that contact took place with the all the rigour of science. This evidence is very compelling.

The examination itself takes place in a medical room, a little like a Practice Nurse room where women have their cervical smear test, or a GP surgery. Sometimes these rooms are in a clinic facility, and sometimes attached to a police facility.

The FP and nurse will ask you to remove your clothing and you will get a disposable modesty gown and blanket/sheet to keep you covered during the exam. The clinicians will take a note of any injuries on your body such as abrasions, fingerprint bruising or any cuts and document them thoroughly. The swabs taken will be from intimate areas such as breasts, the vaginal area and/or the back passage. There are swabs that are taken internally with the use of a speculum- in the vagina, and a proctoscope - in the bottom. The proctoscope is in for seconds only. Often, there are few or no injuries found, this does not diminish the severity of your experience or throw doubt into your account of events- it is very common. It is likely that DNA will be found that places the accused in contact with you. This is part of corroboration.

The FP, uses a piece of equipment called a ‘colposcope’ which is a camera that enlarges the view of your soft tissue inside your vagina. It has a good light source and magnification so that they can see any injuries at all, even the tiniest.

It may be that you will be asked for a blood sample, and this is only for forensic purposes. This can establish if there are any other substances in your system, such as alcohol and drugs, including prescribed medications.

Then it is done. It is hard to say how long it would take, probably about one hour from start to finish including all the talking- the process of reporting and then going home can be drawn out and full of emotional labour. However, it is an opportunity to have the ‘science’ part of your case completely done, sorted and out of the way.

It is an opportunity in time, and reasonably fleeting. The best evidence is obtained closest to the time of the assault, but can be examined for up to seven days later. The later it is, the fainter the trace.

At the end, you will be offered medication to prevent conception if you want it, and an information pack about Rape Crisis, and also, the Sexual Health clinics on offer that can support you and how to organise to have testing for sexually transmitted infections (STIs). You will have a dedicated number to call to make an appointment at Chalmers Centre or you can go and see your own GP, so that you can choose the best option for you.

These tests are performed 14 days after the assault and can be performed at Chalmers Centre or at your GP. You can go to a specialist sexual assault clinic as part of these options, but in all clinics, even the anonymous one, you will be asked about sexual assault- and that is so that the doctors and nurses can offer you the BEST support and ensure you have the right tests.

You will be given a leaflet that explains more about these infections and how to access the services. It might not feel like it right now, but you have a right to claim the intimate life you want, and having knowledge about STIs will help you make clear choices in your future.

There is a shower room in most facilities, and sanitary products and fresh underwear are available.

These are the practical aspects of a forensics examination. The emotional aspects are quite different. Rape is a shocking crime, it is complex and brutal. You can keep in touch with ERCC, and their dedicated staff can help you make sense of what has happened and start your recovery.

Thanks for reading and don’t be afraid to contact ERCC and tell your story. You are incredibly important.

#forensics